Effects of sugar intake on body weight: a review.

Weight reduction programmes are mainly focused on reducing intake of fat and sugar. In this review we have evaluated whether the replacement of dietary (added) sugar by low-energy sweeteners or complex carbohydrates contributes to weight reduction. In two experimental studies, no short-term differences in weight loss were observed after use of aspartame as compared to sugar in obese subjects following a controlled energy-restricted diet. However, consumption of aspartame was associated with improved weight maintenance after a year. In two short-term studies in which energy intake was not restricted, substitution of sucrose by artificial sweeteners, investigated mostly in beverages, resulted in lower energy intake and lower body weight. Similarly, two short-term studies, comparing the effect of sucrose and starch on weight loss in obese subjects did not find differences when the total energy intake was equal and reduced. An ad libitum diet with complex carbohydrates resulted in lower energy intake compared to high-sugar diets. In two out of three studies, this was reflected in lower body weight in subjects consuming the complex carbohydrate diet. In conclusion, a limited number of relatively short-term studies suggest that replacing (added) sugar by low-energy sweeteners or by complex carbohydrates in an ad libitum diet might result in lower energy intake and reduced body weight. In the long term, this might be beneficial for weight maintenance. However, the number of studies is small and overall conclusions, in particular for the long term, cannot be drawn.

No effect of dietary trans isomers of alpha-linolenic acid on platelet aggregation and haemostatic factors in european healthy men. The TRANSLinE study.

The aim of this study was to investigate the effect of trans alpha-linolenic acid on platelet aggregation and blood haemostasis. A randomized, double blind dietary intervention trial was carried out with healthy male volunteers (n=88) in three European centers. After a 6-week washout period where subjects avoided foods containing all trans fats, subjects either continued for 6 weeks with a low trans diet or a diet where trans alpha-linolenic acid provided 0.6% of energy (supplied as oil, margarine, cheese, muffins, and biscuits). At the end of the washout period the intake of trans polyunsaturated fats was 58+/-115 mg/day; this increased in patients on the high trans diet by +1344+/-328 mg/day, compared with +10+/-67 mg/day in patients on the low trans diet (p<0.01). The change in trans alpha-linolenic acid in plasma cholesteryl esters was 0.26+/-0. 20 on the high trans and 0.00+/-0.07% of fatty acids on the low trans diet (p<0.001). No effect of the high trans diet was observed on platelet aggregation: collagen EC(50) high trans 157+/-100, low trans 152+/-90 ng/mL (NS); U44619 EC(50) high trans 81+/-61, low trans 59+/-27 nM (NS). The high trans diet did not affect platelet thromboxane production, fibrinogen levels, factor VII, activated factor VIIa, or plasminogen activator inhibitor activity. There were no center-specific differences in response to the high trans diet. A relatively high amount of trans alpha-linolenic acid for 6 weeks does not increase the risk of coronary heart disease by promoting platelet aggregation and blood coagulation.

The metabolism of linoleic acid in healthy subjects after intake of a single dose of (13)C-linoleic acid.

OBJECTIVE: To investigate the in vivo oxidation of (13)C18:2n-6 and its conversion into longer-chain polyunsaturates (LCPs) in healthy subjects. DESIGN: Blood samples were collected from six subjects before (fasted) and 7, 11 (non-fasted), 24, 48, 72, 168 and 336 h (fasted) after ingestion of a single bolus of 45 mg uniformly labeled (13)C18:2n-6 dissolved in 8 g olive oil. In three subjects, breath was also sampled and CO(2) production measured every hour during the first 12 h. Subjects consumed their habitual diets. Plasma (13)C-enrichments were measured by GC-C-IRMS and fatty acid compositions by GC/FID. SETTING: Maastricht University, Department of Human Biology. SUBJECTS: Three men and three women, recruited by local advertisement. RESULTS: The tracer/tracee ratio (TTR) of C18:2n-6 in plasma total lipids was already increased 5 h after tracer intake. The mean peak amount (+/-s.e.m) of (13)C18:2n-6 (3.4+/-0.8 mg; 7.6% of dose) was found after about 17 h, (13)C18:3n-6 (0.018+/-0.008 mg; 0.04% of dose) after 7-48 h, and (13)C20:3n-6 (0.028+/-0.011 mg; 0.06% of dose) after 48-336 h. Time to peak TTRs of C20:4n-6 varied between subjects and were on average 0.022+/-0.006 mg (0.05% of dose). The proportion of (13)C18:2n-6 recovered in breath after 12 h ranged between 16.8 and 25.1%. CONCLUSIONS: These findings suggest that a single bolus of 45 mg U-(13)C18:2n-6 can be used to study the oxidation of (13)C18:2n-6. However, because of the low TTRs for C20:4n-6, a higher dose is recommended for studying the conversion of (13)C18:2n-6 into LCPs. In addition, since only about 35% of the tracer was found in plasma total lipids and as (13)CO(2) in breath, it might be necessary to study other accessible lipid fractions as well to study the overall conversion of linoleic acid.

The effect of dietary trans alpha-linolenic acid on plasma lipids and platelet fatty acid composition: the TransLinE study.

OBJECTIVE: To collect (i) baseline data and (ii) execute a large multicentre study examining the effect of trans alpha-linolenic acid on its incorporation into plasma lipids and on risk factors for coronary heart disease. DESIGN: Male volunteers were recruited and the habitual diet assessed by a 4-d weighed record. Fatty acid composition of plasma and platelet lipids were determined by gas chromatography at baseline. After a 6 week run-in period on a trans 'free' diet, male volunteers were randomised to consume 0.6 % of energy trans alpha-linolenic acid or to continue with a diet 'low' in trans alpha-linolenic acid for 6 weeks. SETTING: Three European university research departments supported by the research and development departments of the food industry. SUBJECTS: Male volunteers (88) recruited by local advertisement. METHODS: Replacement of 30 % of the fat of the habitual diet by margarine, oil and foods. Rapeseed oil was deodorised especially to produce the trans 'free' and 'high' trans foods for this study. The incorporation and conversion of trans alpha-linolenic acid into plasma lipids and platelets was assessed by gas chromatography and dietary compliance was verified by 4-d weighed record. RESULTS: Less trans alpha-linolenic acid isomers are incorporated into human plasma lipids in French volunteers than in Dutch or Scottish volunteers consuming their habitual diets. Trans 'free' alpha-linolenic acid-rich oil can be produced by careful deodorization during refining. The 'high' trans diet provided 1410+/-42 mg/d trans isomers of alpha-linolenic acid, whilst the 'low' trans group consumed 60+/-75 mg/d. The change in plasma lipid and platelet fatty acid composition documented that trans linolenic isomers are incorporated and converted to a trans isomer of eicosapentaenoic acid. Only the 15-trans alpha-linolenic acid is incorporated into plasma cholesteryl esters. The group consuming low trans diet had a slightly higher intake of fat, especially saturated and monounsaturated fat. CONCLUSIONS: Trans 'free' rapeseed oil, rich in alpha-linolenic acid, can be produced by careful deodorization. Dietary records show good compliance. Dietary trans isomers of alpha-linolenic acid are incorporated in plasma lipids and converted to long-chain polyunsaturated fatty acids. Their effects on risk factors for coronary heart disease and their metabolism will be reported elsewhere. SPONSORSHIP: European Commission (FAIR 95-0594 grant). European Journal of Clinical Nutrition (2000) 54, 104-113

Effects of dietary alpha-linolenic acid on the conversion and oxidation of 13C-alpha-linolenic acid.

The effects of a diet rich in alpha-linolenic acid vs. one rich in oleic acid on the oxidation of uniformly labeled 13C-alpha-linolenic acid and its conversion into longer-chain polyunsaturates (LCP) were investigated in vivo in healthy human subjects. Volunteers received a diet rich in oleic acid (n = 5) or a diet rich in alpha-linolenic acid (n = 7; 8.3 g/d) for 6 wk before and during the study. After 6 wk, subjects were given 45 mg of 13C-alpha-linolenic acid dissolved in olive oil. Blood samples were collected at t = 0, 5, 11, 24, 96, and 336 h. Breath was sampled and CO2 production was measured each hour for the first 12 h. The mean (+/- SEM) maximal absolute amount of 13C-eicosapentaenoic acid (EPA) in plasma total lipids was 0.04 +/- 0.01 mg in the alpha-linolenic acid group, which was significantly lower (P = 0.01) than the amount of 0.12 +/- 0.03 mg 13C-EPA in the oleic acid group. Amounts of 13C-docosapentaenoic acid (DPA) and 13C-docosahexaenoic acid (DHA) tended to be lower as well. The mean proportion of labeled alpha-linolenic acid (ALA) recovered as 13CO2 in breath after 12 h was 20.4% in the ALA and 15.7% in the oleic acid group, which was not significantly different (P = 0.12). The cumulative recovery of 13C from 13C-ALA in breath during the first 12 h was negatively correlated with the maximal amounts of plasma 13C-EPA (r = -0.58, P = 0.047) and 13C-DPA (r = -0.63, P = 0.027), but not of 13C-DHA (r = -0.49, P = 0.108). In conclusion, conversion of 13C-ALA into its LCP may be decreased on diets rich in ALA, while oxidation of 13C-ALA is negatively correlated with its conversion into LCP. In a few pilot samples, low 13C enrichments of n-3 LCP were observed in a diet rich in EPA/DHA as compared to oleic acid.

Dietary trans alpha-linolenic acid from deodorised rapeseed oil and plasma lipids and lipoproteins in healthy men: the TransLinE Study.

TRANS: isomers of alpha-linolenic acid, which are formed by deodorization of refined vegetable oils, can be found in significant amounts in edible oils. Effects of trans alpha-linolenic acid on plasma lipoproteins are unknown. We therefore investigated the effects of trans alpha-linolenic acid on plasma lipids and lipoproteins in healthy European men. Eighty-eight healthy men from three European countries (France, Scotland, UK and the Netherlands) first consumed for 6 weeks a diet with experimental oils 'free' of trans fatty acids (run-in period). For the next 6 weeks, they were randomly allocated to a diet with experimental oils 'high' or 'low' in trans alpha-linolenic acid. Daily total trans alpha-linolenic acid intake in the high trans group was 1410 (range 583-2642) mg. Experimental oils were provided as such, or incorporated into margarines, cheeses, muffins and biscuits. The high trans alpha-linolenic acid diet significantly increased the plasma LDL-:HDL-cholesterol ratio by 8.1 % (95 % CI 1.4, 15.3; and the total cholesterol:HDL-cholesterol ratio by 5.1 % (95 % CI 0.4, 9.9; compared with the low-trans diet. This was largely explained by an increase in LDL-cholesterol on the high-trans diet, while no change was observed in the low-trans group (mean treatment effect of 4.7 % (95 % CI -0.8, 10.5; No effects were found on total cholesterol and HDL-cholesterol, triacylglycerols, apolipoprotein B and A-1, and lipoprotein(a) concentrations. In conclusion, trans alpha-linolenic acid may increase plasma LDL-:HDL-cholesterol and total cholesterol:HDL-cholesterol ratios. Whether diet-induced changes in these ratios truly affects the risk for CHD remains to be established.

Alcohol consumption stimulates early steps in reverse cholesterol transport.

Alcohol consumption is associated with increased HDL cholesterol levels, which may indicate stimulated reverse cholesterol transport. The mechanism is, however, not known. The aim of this study was to evaluate the effects of alcohol consumption on the first two steps of the reverse cholesterol pathway: cellular cholesterol efflux and plasma cholesterol esterification. Eleven healthy middle-aged men consumed four glasses (40 g of alcohol) of red wine, beer, spirits (Dutch gin), or carbonated mineral water (control) daily with evening dinner, for 3 weeks, according to a 4 x 4 Latin square design. After 3 weeks of alcohol consumption the plasma ex vivo cholesterol efflux capacity, measured with Fu5AH cells, was raised by 6.2% (P < 0.0001) and did not differ between the alcoholic beverages. Plasma cholesterol esterification was increased by 10.8% after alcohol (P = 0.008). Changes were statistically significant after beer and spirits, but not after red wine consumption (P = 0.16). HDL lipids changed after alcohol consumption; HDL total cholesterol, HDL cholesteryl ester, HDL free cholesterol, HDL phospholipids and plasma apolipoprotein A-I all increased (P < 0.01). In conclusion, alcohol consumption stimulates cellular cholesterol efflux and its esterification in plasma. These effects were mostly independent of the kind of alcoholic beverage